Nutrition to Help Concussions
By Britni Vincent, RD, LD
March 10, 2020
As more and more concussion research is coming out every year, experts are finding out all the potential effects of even just one concussion. Historically, not much was known about what happens to the brain after a concussion since it’s very difficult to study the brain. First, let’s set the stage a concussion is a traumatic brain injury (TBI) that affects your brain function. The brain is made of soft tissue and is cushioned by spinal fluid and encased in the protective shell of the skull. When you sustain a concussion, the impact can jolt your brain and sometimes, it literally causes it to move around in your head. Concussions are usually caused by being hit on the head or violently shaking the head and upper body. You might assume that you lose consciousness when you have a concussion, but that’s not always the case. After a concussion there can be bruising, damage to blood vessels, damage to nerves, an increase in free radicals, cell death and a reduction in blood flow to the brain.
Effects are usually temporary but can include headaches and problems with concentration, memory, balance, dizziness, ringing in the ears, nausea, slurred speech, fatigue and coordination. Keep in mind that some symptoms may be delayed for hours or days after the concussion occurs; these symptoms may be concentration and memory problems, mood changes, sensitivity to light and noise, sleep disturbances, psychological adjustment problems, and disorders of taste and smell. Some individuals develop post-concussion syndrome, which is a complex disorder in which various symptoms last for weeks and sometimes months after the injury occurred.
Most people are surprised to learn that food choices can have a big impact on concussion symptoms but it really makes sense, as the brain is the most nutrient-dependent organ in the human body. I have seen clients with post-concussion syndrome so severe it seriously impacted their quality of life and ability to function at school or work. It was amazing to watch as nutrition and proper supplementation made a huge difference in their symptoms and see them able to start living their old life again. It was so helpful that I highly encourage you to start thinking about your food choices as brain food. What you put in your mouth should nourish and help heal your brain. While more research is needed on concussions I wanted to share some general nutrition recommendations for concussions.
What to Eat After a Concussion
Protein – Protein is critical for brain healing, including to heal any damaged brain tissue. When your body is healing from any injury your protein needs are higher. I would recommend three to five ounces at breakfast, four to six ounces at lunch and dinner and two ounces at snacks (men should consume the upper amounts of these ranges). Start increasing your protein right after the injury. Focus on animal sources of protein such as: eggs, beef, chicken, fish, seafood, turkey, and yogurt and cottage cheese (if you are not dairy sensitive). Choosing organic, grass fed, pasture raised, free range animal sources is best as they are higher in beneficial fats, lower in inflammatory fats and are overall more nutrient dense. If you’re struggling with nausea or lack of appetite, try our delicious smoothie recipes that are packed with protein.
Protein is also important after a concussion because it is one of the best sources of magnesium. Research has shown that magnesium levels in the brain drop significantly after a concussion which can slow down the healing process1. Meat is one of the best sources of magnesium.
Healthy Fat – The numbers speak for themselves; 70-80% of your brain is made up of fat! Since most of the brain is made up of fat, imagine how an already inflamed brain is going to function on a low-fat diet or consuming refined oils that are inflammatory … not very well. Healthy fat is brain food. Health fats are avocado, raw or dry roasted nuts, avocado oil, coconut oil, olives, olive oil, avocado oil mayonnaise, coconut milk, and grass-fed butter. Avoid the refined oils that are inflammatory such as corn, soybean, canola, vegetable, and cottonseed oils. By looking at the ingredient list on any food product you’ll find these oils in so many foods. If you see any of these refined oils in the ingredient list, just put it back on the shelf. Aim to eat healthy fat every single time you eat.
Omega-3 Fatty Acids – As mentioned 70-80% of your brain is fat, and 30% of that is made up of omega-3 fats. Omega-3 fatty acids are essential fatty acids, meaning your body doesn’t just make them; you must get them from food. Focus on two kinds of omega-3s that provide the most therapeutic benefits, EPA and DHA. DHA helps to build strong, flexible cell membranes in neurons, and EPA helps to reduce the inflammatory response. This could get a little sciency but omega-3s also help with neuroprotection and neuroregeneration after a concussion.. The best food sources of omega-3s are fatty fish such as salmon, mackerel, sardines, oysters and trout.
Realistically people don’t consume enough fatty fish to get the amount of omega-3s needed, and that’s where supplementing comes in. Omega-3 supplementation immediately following a concussion has been found to be extremely beneficial. We’ve witnessed this with many of our clients, and in a research review published in the Journal of the American College of Nutrition, Dr. Michael Lewis suggests that there are benefits of aggressively adding omega-3 fatty acids to optimize the healing of TBIs, concussions and post-concussion syndrome2. Dr. Michael Lewis has years of clinical experience working with patients who have had a TBI, concussion or post-concussion syndrome. We had him on our Dishing Up Nutrition podcast. In addition to Dr. Lewis’ findings, other research has shown the capacity of omega-3 fatty acids to counteract some of the effects of TBI by normalizing levels of molecular systems in the brain3.
Dr. Lewis has developed an omega-3 protocol to follow after a concussion4 which we have used with good success many times. His recommendation is to have three omega-3 capsules with each meal the first week, two omega-3 capsules with each meal the second week and then the third week reduce to a maintenance dose of three capsules per day. If symptoms return after reducing one of the dosages, increase the dose for another week or two then try to reduce again. It is crucial you are using a high quality omega-3 supplement.
Vegetables – By increasing your vegetable consumption you’re increasing your antioxidant intake. One study done at Western Virginia University found that antioxidants given to rats after a concussion reduced the amount of cell death and the long-term effects of the concussion5. Try spaghetti squash or zucchini noodles instead of pasta, have berries with your afternoon snack instead of candy, sauté lots of greens with your eggs in the morning instead of a piece of toast.
What Foods to Avoid After a Concussion
Sugar and Processed Carbs – Since concussions cause inflammation in the brain the goal is to reduce that inflammation, which you can with your food choices. It’s probably no surprise that sugar and processed carbs will only exacerbate that brain inflammation. Since more inflammation isn’t the goal, it is best to limit or eliminate them. Remember, all carbohydrates break down to sugar in the body so this doesn’t just mean the obvious sugary foods like candy, but also includes all kinds of cereal, granola bars, pizza, and the list can go on and on.
Dairy and Grains (For Extreme Cases) – Some individuals who have a lot of symptoms or have post-concussion syndrome may need to take it a step further and eliminate all dairy and grains. I have had clients with post-concussion syndrome notice a significant difference in their symptoms once they eliminated dairy and grains. This includes cheese, heavy cream, milk, yogurt, rice, bread, quinoa, and corn because it’s a pseudo-grain (meaning our body responds to it like a grain).
Many of you reading may be thinking, well what’s left to eat? I think it’s always a good idea to focus on the foods to incorporate in your diet versus focusing on the ones that you’re eliminating. Good news is there are still plenty of yummy foods left if you’re grain and dairy free: healthy fats (avocado, olives, olive oil, coconut milk, raw or dry roasted nuts and seeds and avocado oil), vegetables, starchy vegetables like sweet potato and winter squash, fruit (berries are best because they’re high in antioxidants and low in sugar), and protein (eggs, chicken, beef, turkey, fish and seafood). We have many delicious recipes that fit these criteria or can be easily tweaked to make them dairy and grain free. It may be helpful to think of this as doing an experiment on your body. So, do an experiment and eliminate the grains and dairy from your diet for a month and see if your concussion or post-concussion symptoms reduce. If they do, I guarantee you’ll be highly motivated to steer clear of those foods. It’s possible that once your brain does some healing you may be able to safely re-introduce some of those foods.
If you’re feeling overwhelmed after reading this, that’s alright; we’re here to help! If you feel like you need additional support during this process or if you’re struggling with post-concussion syndrome I’d highly recommend making an appointment with one of our nutritionists (available in-person or by phone). These are general recommendations, and there may be additional supplements and food modifications that would be beneficial for you.